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Free Video Game Gambling Establishment: A Guide to Online Casino Site Games
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上热下寒证,不可忽视这首“柴胡桂枝干姜汤”!
柴胡桂枝干姜汤(简称柴胡桂姜汤)出自《伤寒论·辨太阳病脉证并治下》第147条,也见于《金匮要略·疟病脉证并治第四》的“附《外台秘要》方”。本方目前仍较广泛地应用于临床,但历代医家对本方的病机及方解认识不一,争论较多。笔者参考了相关书籍以及近十年的文献报道,试从病机、方解及现代临床应用方面做综述如下,并提出自己的认识。 春藥 美國春藥網 催情藥 迷藥 壯陽藥 媚藥 乖乖水 FM2 女士催情藥 男士壯陽藥 昏睡迷幻藥 增大增粗藥 延時持久液迷媚 強效催情藥 性藥之王 DDK藥效 迷姦粉 迷昏粉 迷昏藥 乖乖水 洗腦聽話藥 聽話水 瀰漫之夜 惡魔丘比特 超強春藥 香耐爾 狂愛催情水 一、病机释义 《伤寒论·辨太阳病脉证并治下》第147条:“伤寒五六日,已发汗而复下之,胸胁满微结,小便不利,渴而不呕,但头汗出,往来寒热,心烦者,此为未解也,柴胡桂枝干姜汤主之。”历代医家对本方的病机主要有以下几种认识。 1、少阳病兼水饮内结 伤寒汗下后,邪入少阳,枢机不利,因手足少阳经常相互影响,足少阳枢机不利,疏泄失常,手少阳三焦因之壅滞,决渎失职,而致水饮内结。持此见解者以当代注家居多,如《伤寒论讲义》二版、四版、五版,《伤寒论选读》,《伤寒论译释》,《中国汤液方证》,日本吉益东洞的《类聚方》及汤本求真的《皇汉医学》等。 唐容川于《伤寒论浅注补正·太阳篇》论“水饮内动,逆于胸胁,故胸胁满微结,小便不利。水结则津不升,故渴,此为猪苓汤证同一意也”,也从“水饮内结”发微。陈慎吾将柴胡桂枝干姜汤证概括为“少阳证而有阴证转机之人用之”,即认为本方主治小柴胡汤证而有脾阳虚及心阳虚,阳虚不能化气而致水湿内停之人。 2、胆火内郁兼太阴虚寒 刘渡舟在《伤寒论通俗讲话》中指出:“邪陷少阳,气郁不舒,故胸胁满微结;胆火上炎而灼津,故心烦口渴;热郁不得宣泄而上蒸,故头汗出;正邪分争,故往来寒热;无关乎胃,故不呕;三焦气机阻滞,所以小便不利;内伤脾气,太阴虚寒,故见腹满或大便溏泻。此证为胆热脾寒,故治以清少阳之热,兼温太阴之寒。” 3、半表半里阴虚寒证 胡希恕在论此条时说:“伤寒五六日,虽已发汗,并不解则常转入少阳柴胡证,医者不详查,而又误用下法,津伤甚,由阳证转化为阴证,虽胸胁满未去,但呈现微结。汗、下、邪热皆伤津液,津液不下,故小便不利;津液虚少,热伤津致燥,故渴而不呕;气冲于上,故但头汗出;往来寒热,为邪还在半表半里;心烦,为上有热。” 这里的“微结”,是针对大陷胸汤证说的,即是说此结轻微,与大陷胸汤证结如石硬为阳明证者显异。此证已转化为半表半里阴虚寒证,即呈寒热错杂、上热下寒的柴胡桂枝干姜汤的方证。美國威樂 美國威樂官網 vigrxplus 威樂增大丸 vigrx威樂 vigrx威樂瓶裝增大丸 vigrx威樂增大軟膏 vigrxplus威樂盒裝增大丸 vigrx威樂持久液 vigrx威樂前列腺改善 vigrx威樂瑪卡 此外,有关本方病机的论述,还有少阳病兼表邪不解,如清代医家尤在泾《伤寒贯珠集》及现代裴永清之《伤寒论临床应用五十论》支持此观点;成无已《注解伤寒论》和汪苓友《伤寒论辨证广注》认为病机为少阳病兼津伤;聂惠民《伤寒论与临证》认为是少阳病兼气化失常;畅洪升认为此方为气郁为本,痰结为标;而冉雪峰《冉注伤寒论》认为是汗下邪陷,阴阳两伤。